Department of Kinesiology, University of Georgia, 330 River Road, Room 353, Athens, GA, 30602, USA.
Curr Osteoporos Rep. 2020 Feb;18(1):47-56. doi: 10.1007/s11914-020-00561-y.
The goal of this review is to highlight the deficits in muscle and bone in children with cerebral palsy (CP), discuss the muscle-bone relationship in the CP population, and identify muscle-based intervention strategies that may stimulate an improvement in their bone development.
The latest research suggests that muscle and bone are both severely underdeveloped and weak in children with CP, even in ambulatory children with mild forms of the disorder. The small and low-performing muscles and limited participation in physical activity are likely the major contributors to the poor bone development in children with CP. However, the muscle-bone relationship may be complicated by other factors, such as a high degree of fat and collagen infiltration of muscle, atypical muscle activation, and muscle spasticity. Muscle-based interventions, such as resistance training, vibration, and nutritional supplementation, have the potential to improve bone development in children with CP, especially if they are initiated before puberty. Studies are needed to identify the muscle-related factors with the greatest influence on bone development in children with CP. Identifying treatment strategies that capitalize on the relationship between muscle and bone, while also improving balance, coordination, and physical activity participation, is an important step toward increasing bone strength and minimizing fractures in children with CP.
本文旨在强调脑瘫（CP）患儿的肌肉和骨骼缺陷，讨论 CP 人群的肌肉-骨骼关系，并确定可能刺激其骨骼发育改善的基于肌肉的干预策略。
最新研究表明，即使是运动功能轻度障碍的 CP 患儿，其肌肉和骨骼的发育也严重不足且较弱。肌肉体积小、功能差，以及体力活动参与度有限，可能是 CP 患儿骨骼发育不良的主要原因。然而，肌肉-骨骼关系可能因其他因素而变得复杂，如肌肉中脂肪和胶原蛋白的高浸润程度、异常的肌肉激活和肌肉痉挛。基于肌肉的干预措施，如阻力训练、振动和营养补充，有可能改善 CP 患儿的骨骼发育，尤其是在青春期前开始干预。需要研究来确定对 CP 患儿骨骼发育影响最大的肌肉相关因素。确定利用肌肉和骨骼之间的关系的治疗策略，同时改善平衡、协调和体力活动参与度，是提高 CP 患儿骨强度和减少骨折的重要步骤。
